Outcomes of Displaced Greater Tuberosity Fractures Treated with Screw Fixation and Double Row Suture Bridge Technique

Closed treatment of comminuted, displaced greater tuberosity fractures (GTFs) can result in nonunion or malunion, causing rotator cuff dysfunction and/or subacromial impingement. This study evaluates the outcomes and complications of combined suture anchor and screw fixation technique for the treatment of GTFs.

This retrospective case series included 13 patients with displaced GTFs (> 5 mm) who underwent screw and double-row suture bridge fixation from 2019 to 2024 at a single institution. Patient demographics, injury mechanisms, fracture characteristics, associated injuries, and operative data were collected. All fractures were fixed using screw and double row suture bridge fixation via a lateral deltoid split approach. Postoperative outcomes included range of motion, Patient-Reported Outcome Measurement Information System (PROMIS) scores, American Shoulder and Elbow Surgeons (ASES), Visual Analogue Scale (VAS), radiographic outcomes, and postoperative complications.

Thirteen patients (13 shoulders; 9 males, 4 females) with a mean age of 53.2 (29-73) years were followed for an average of 11.7 (6-27) months. The most common mechanism of injury was a traumatic fall (9/13). The mean postoperative PROMIS Upper Extremity score was 42.7 ± 8.9, and the mean ASES score was 79.3 ± 13.8. Latest postoperative radiographs showed evidence of healed fractures in 12 out of 13 patients (92%) with no further fracture displacement. Two patients (15%) required reoperation: one for screw migration/loosening and one for late infection with greater tuberosity resorption and screw displacement.

Treatment of displaced GT fractures with combined screw fixation and double row suture bridge technique results in predictable fracture healing and favorable functional outcomes. Limitations include the retrospective case series design, small cohort size, and absence of a control group.

IV, case series.